I just read an interesting article in the Journal of Pediatrics that show accidental drug poisonings in children are now on the rise! Calls to poison control centers about children ingesting drugs had dropped between 1990 -2000, but rose 22% from 2001-2008 , despite an only 8% increase in the childhood population during the same time period.
The data was obtained from The National Poison Data System. Over 500,000 children less than 5 years of age had accidentally ingested medications and more than 50,000 were seen in the ER.
So, it seems that our children are "accidentally" getting into more drugs whether it is an OTC product, or prescription medications. Prescription medications such as narcotics for pain, sedatives, sleeping agents and cardiovascular medications accounted for the majority of ER visits and also accounted for 76% of hospital admissions and 71% of the significant injuries. There were 66 ingestion related deaths.
Medication overdoses due to dosage error seem to be stabilizing with increased efforts to educate and simplify dosage instructions on most OTC products. But as more and more drugs seem to be available in households, efforts to prevent accidental ingestions are paramount.
It always seems that children somehow can open "childproof caps" and many parents and grandparents are on multiple medications which they then put in the convenient daily pill dose dispensers which typically are not "childproof". Older siblings who may also be on medication for ADHD may also not be as diligent about putting their medications up and away.
Once a child is walking, the medicine cabinet needs to be up and out of reach, and should also have a lock. Toddlers are cunning and as they watch you open the cabinet everyday and take out pretty pink, yellow and blue pills, they may be "plotting" how they too can get to those pretty colored candies! It is amazing that even though they may taste bitter and disgusting to us, a toddler can eat a whole bottle, despite the fact that they won't touch their dinner.
At the same time, many of the newer drugs may only take 1 or 2 pills to cause significant morbidity in young child.
Check out your house and see if you have pill bottles that are not put up and locked up. Throw out unused and leftover medications so that there are actually fewer medications in the home. Talk to grandparents and older children as well about "childproofing medications".
At the same time drug companies may consider other ways to limit access to drugs, maybe with blister drug packs? What about the packaging that CD's and remote control toys come in, no one seems to be able to open those?
That's your daily dose for today. I'm Dr. Sue Hubbard from The Kid's Doctor.
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I recently received a question from a Twitter follower related to cradle cap and dandruff. She wanted to know if there was a difference in the two.
You know there really isn't as they are both to...
You know there really isn't as they are both due to seborrheic dermatitis, an inflammatory condition of the skin in which the skin overproduces skin cells and sebum (the skins natural oil).
Cradle cap is the term used for the scaly dermatitis seen on the scalp in infants. It is also seen on the eyelids, eyebrows, and behind the ears. It is typically seen after about three months of age and will often resolve on its own by the time a baby is eight to 12 months old. It is usually simply a cosmetic problem for a baby as it looks like a yellowish plaque on a baby's scalp and is often not even noticed by anyone other than the parents.
Unlike seborrheic dermatitis in adults, cradle cap typically doesn't itch. It is thought that cradle cap may occur in infancy due to hormonal influences from the mother that were passed across the placenta to the baby.
These hormones cause the sebaceous glands to become over active. In some severe cases an infant's scalp becomes really scaly and inflamed and causes even more parental concern, as it appears that the infant is uncomfortable and may be trying to scratch their head by rubbing it on surfaces.
The treatment for cradle cap is to wash the baby's scalp daily with a mild shampoo and then to use a soft comb or brush to help remove the scales once they have been loosened with washing. When washing the head make sure to get the shampoo behind the ears and in the brows (keeping the soap out of baby's eyes).
This is usually sufficient treatment for most cradle cap. In situations where the greasy scales seem to be worsening it may help to put a small amount of mineral oil or olive oil on the baby's head and let it sit (I left a small amount on my children's heads overnight) and then to shampoo the following day. The oil will help the scales to loosen up and come off more easily.
For babies that have very inflamed irritated cradle cap a visit to your pediatrician may be warranted to confirm the diagnosis. In persistent cases I often recommend shampooing several times a week with a dandruff shampoo that has either selenium (Selsun) or zinc pyrithione (Head and Shoulders) making sure not to get any in the infant's eyes. I may then also use a hydrocortisone cream or foam on the scalp that will lessen the inflammation and itching. In these cases it may take several weeks to totally clear up the problem.
As children get older, especially during puberty, you may see a return of seborrhea as dandruff. Again you can use dandruff shampoos. It also seems that with the overproduction of sebum there is an overgrowth of a fungus called malessizia so using a shampoo for dandruff as well as a antifungal shampoo (Nizoral) often works.
I have teens alternate different shampoos, as sometimes it seems to work better than always using the same shampoo for months on end. Teens don't like white flakes falling from their scalp and unlike a baby, a teen is worried about the cosmetic issues of seborrhea!
That's your daily dose, we'll chat again tomorrow.
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